The concept of the show is that each main event match is contested as an Elimination Chamber match. The event's name was voted by fans via WWE's official website and was chosen over Heavy Metal, Battle Chamber, Chamber of Conflict and the original No Way Out name.

Since its origin, the event has been held only in indoor arenas in the United States. Championship bouts are scheduled on every card, with the lower-tier titles featured on the undercard and the top-tier featured on the main card. Under the Brand Extension, WWE assigned its performers to either Raw or SmackDown which caused matches to be set up between wrestlers on the same show.